Total Knee Replacement
Your knee joint is made up of the lower end of the femur,
which hinges on the upper end of the tibia, and the patella, or kneecap,
which slides along the groove formed by the femoral condyles.
Total knee replacement surgery is a procedure in which a painful or poorly functioning knee is replaced with artificial components.
If your physician has recommended a total knee replacement,
it is probably because your knee is severely damaged by arthritis or injury.
Before your procedure, you'll be given intravenous fluids, antibiotics and medications to help you relax.
A catheter may be placed in your bladder to drain your urine.
Knee replacements may be done under general anesthesia
in which case a breathing tube will be inserted in your throat to help you breathe during the operation.
Or, you may receive spinal or epidural anesthesia,
in which case, you will remain awake throughout the procedure, but your legs will be anesthetized.
Since blood and fluid loss is sometimes significant, donated blood may be prepared in case you require a transfusion.
Most total knee replacements take approximately two hours.
Your surgeon will begin by making an incision along the front edge of your knee.
After separating the muscles and ligaments around your knee, your surgeon will incise the knee capsule to gain access to the inside of the joint.
Using specialized tools, your surgeon will remove the damaged bone and cartilage on the ends of the femur and the tibia,
and in most cases, remove the underside of the patella.
Your surgeon will then prepare the remaining bone to receive your new prosthetic knee.
This generally consists of a femoral, a tibial, and a patellar component.
Once the ends of the bones are prepared, your surgeon will cement the new prostheses into position.
Before your incision is closed, an x-ray will be taken to ensure that the new components of your knee are positioned correctly.
Your surgeon will close the incision with stitches or staples and temporarily leave a drain in place to remove excess fluid.
Immediately following the operation, a splint will be applied to help hold your knee in the appropriate position.
You will then be moved to the recovery area for monitoring.
If necessary, you may receive a blood transfusion at this time.
Once stable and awake from the anesthesia,
you will be transferred to your hospital room where you will continue to receive intravenous antibiotics for a short time and given pain medications as needed.
To prevent blood clots from forming in your leg,
you will be given a blood thinner, asked to wear pneumatic compression stockings, and encouraged to begin walking as soon as possible after the procedure.
A nurse or physical therapist will help you get out of bed and begin using your new knee.
Most patients are released from the hospital once they are able to walk with the aid of a crutch or walker.
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